title: Fibroid infected with Escherichia coli requiring surgical removal following uterine artery embolization.
abstract: BACKGROUND
  Uterine fibroid necrosis and infection is a rare but potentially serious event following uterine artery embolization (UAE). We describe a case of surgical removal of an infected necrotic uterine fibroid.
  
  
  METHODS
  A 31-year-old Jehovah's Witness with severe anemia presented with sepsis following UAE. The uterus was preserved by performing transvaginal surgical removal. Final pathology demonstrated Escherichia Coli infection of the necrotic fibroid. The patient improved postoperatively.
  
  
  CONCLUSIONS
  Surgical removal of an infected necrotic fibroid may be a preferred option for women wishing to avoid hysterectomy following UAE. Appropriate case selection and optimization of hemoglobin concentration before UAE is important to minimize complications.
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto ON.
authors.forename: Lynn
authors.initials: L
authors.lastname: Sterling
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto ON.
authors.forename: Marianne
authors.initials: M
authors.lastname: Boutet
authors.affiliation: Department of Medical Imaging, St. Michael's Hospital, Toronto ON.
authors.forename: Errol
authors.initials: E
authors.lastname: Colak
authors.affiliation: Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto ON.
authors.forename: Guylaine
authors.initials: G
authors.lastname: Lefebvre
mesh_terms: D000328:Adult; D004927:Escherichia coli Infections / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*; D009336:Necrosis / Q000209:etiology / Q000601:surgery; D055357:Uterine Artery Embolization / Q000009:adverse effects*; D014594:Uterine Neoplasms / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*; D019522:Vaginal Discharge / Q000382:microbiology
keywords: embolization; fibroid; infection; interventional radiology; necrosis